I just do not know what to say when I read of the genuine and legitimate panic in places like rural Kentucky over what their governor and the incoming Trump Administration may do to the Medicaid programs on which they depend (from NPR, with a h/t to Alert Tweeter Charlie Pierce):
In Depressed Rural Kentucky, Worries Mount Over Medicaid Cutbacks...In a state as cash-strapped as Kentucky, the increased expenses ahead for Medicaid will be significant in Bevin's view — $1.2 billion from 2017 to 2021, according to the waiver request he's made to the Obama administration to change how Medicaid works in his state.Trump's unexpected victory may help Bevin's chances of winning approval. Before the election, many analysts expected federal officials to reject the governor's plan by the end of the year on the grounds that it would roll back gains in expected coverage.A Trump administration could decide the matter differently, said Emily Beauregard, executive director of Kentucky Voice for Health, an advocacy group that opposes most waiver changes because they could reduce access to care."I think it's much more likely that a waiver could be approved under the Trump administration," she said. "On the other hand, I wonder if the waiver will be a moot point under a Trump administration, assuming that major pieces of the [Affordable Care Act] are repealed."Lockaby is watching with alarm: "I am worried to death about it."Life already is hard in her part of Kentucky's coal country, where once-dependable mining jobs are mostly gone.In Clay County where Lockaby lives, 38 percent of the population live in poverty. A fifth of the residents are disabled. Life expectancy is eight years below the nation's average.Clay's location places it inside an area familiar to public health specialists as the South's diabetes and stroke belt. It's also in the so-called "Coronary Valley" encompassing the 10-state Ohio/Mississippi valley region.About 60 percent of Clay County's 21,000 residents are covered by Medicaid, up from about a third before the expansion. The counties uninsured rate for nonelderly adults has fallen from 29 percent to 10 percent...
And then I read that Republican Matt Bevin carried Clay County in 2015 with 71.1% of the vote, and Donald Trump carried Clay County in 2016 with 89.6% of the vote.
As someone whose family's insurance situation hovers between precarious and disaster and who has finally found a little momentary peace of mind thanks to the Affordable Care Act and a wife who can indefatigably navigate the mightiest soul-killing bureaucracies for weeks on end (I am not kidding), believe me when I say that I really want to help these people. I am just, for the moment, completely out of ideas as to how to get them to stop voting for people who hurt them.
However, I am absolutely certain that some day very soon, the greatest minds of the Beltway punditocracy are finally going to notice the unfolding health care disaster out here in flyover country, after which they will collectively climb up into a very high dudgeon to blame Both Sides for the failure.